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- W4386444048 abstract "In 2018 a perineal protection bundle was introduced to 28 hospitals across Australia aimed at reducing rates of severe perineal trauma (SPT). Pre/post implementation studies of similar programs in other countries have reported outcomes that vary between significant and no reduction in SPT rates. Other consequences such as increased use of episiotomy, contribution to women’s experiences of disrespectful care and loss of midwifery autonomy have also been reported in bundle studies. To date, no studies have examined the effect of the bundle implementation in Australia on the incidence of perineal trauma. To measure the difference in SPT, second degree and episiotomy rates in midwifery led births following the introduction of the perineal protection bundle. Retrospective data was extracted from the perinatal database of a tertiary hospital that had introduced the full perineal bundle. Data for all singleton cephalic vaginal births conducted by midwives during the pre (2011 – 2017) (n=20155) and post-implementation period (2018 – 2020) (n=6273) were analysed. Covariates identified in the literature were explored using univariate analysis, those found to be significant (p=0.05) were included in the multivariate analysis. Following adjustment for independently contributing factors the likelihood of women experiencing SPT did not differ significantly between the pre and post implementation periods. There were significant increases in the use of episiotomy in nulliparous women and the rate of 2nd degree tears in multiparous women. This study adds to the growing body of literature which questions the effectiveness and safety of perineal protection bundles." @default.
- W4386444048 created "2023-09-06" @default.
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- W4386444048 date "2023-09-01" @default.
- W4386444048 modified "2023-09-27" @default.
- W4386444048 title "First do no harm: a single site pre-post implementation study of a perineal protection bundle" @default.
- W4386444048 doi "https://doi.org/10.1016/j.wombi.2023.07.007" @default.
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